The medical context of hypochondriacal traits.

OBJECTIVE: This study examines the effects of two medical contexts on the relationship of hypochondriacal traits and their potential correlates. METHOD: Correlates of hypochondriacal traits were compared from a matched sample of fifty-five general medical inpatients with a sample of fifty-five medical inpatients referred for psychiatric evaluation. Patients completed questionnaires assessing emotional distress and health attitudes, beliefs, and behaviors, and their attending physician completed ratings of the patient's illness and illness behavior. RESULTS: Patients referred for psychiatric consultation exhibited significantly higher levels of hypochondriacal illness presentation than the matched nonreferred sample. Moderated regression analyses revealed three trends regarding the interactive effects of group status on the relationship of hypochondriacal traits to their potential correlates: 1) presence of angry feelings and interpersonal friction was positively associated with hypochondriacal concerns for the psychiatric referred patients only, 2) the tendency to deny life stresses and attribute all problems to the effects of illness was positively associated with a misinterpretation of the severity of their illness and hypochondriacal illness presentation for the psychiatric referred patients, whereas this association was negative for the nonreferred medical patients, and 3) the association of reports of emotional distress symptoms with hypochondriacal illness preparation was negative for the psychiatric referred patients and positive for the nonreferred medical patients. CONCLUSIONS: Study results suggest that hypochondriasis may not represent a uniform nosological disorder and that the context of its study can significantly influence etiologic findings.

Hypochondriacal traits in medical inpatients.

Hypochondriacal traits were examined in 100 general medical inpatients, and correlates of these traits were examined from four perspectives: (1) emotional distress; (2) affective inhibition; (3) learned social behavior; and (4) symptom misinterpretation. In contrast to previous studies of hypochondriasis in general medical populations, this study examined patients' illness perceptions and presentation in relationship to objective health status as assessed by their treating physicians. Data concerning the illness being treated and associated illness behavior were obtained from patients and their treating physicians. Results suggested that hypochondriacal traits of "disease phobia," disease conviction, bodily preoccupation, perceptions that one's illness is more severe than the physician's assessment, and illness presentation disproportionate to demonstrable organic disease were quite prevalent. On multiple regression analyses, correlates pertaining to emotional distress appear to be preeminent in the prediction of hypochondriacal traits. However, variables pertaining to learned social behavior also provided further understanding of hypochondriacal traits in medical inpatients beyond that explained by emotional distress.